Dear Neil,
Here is a small contrbution from my side.
Best, Sanja
Reflection on safe care for NCD in unsafe corners of the world
For over a decade I was deployed in conflict related emergency settings as anaesthetist, mainly in LMICs where most of the conflict were/are happening.
While the main focus of surgical response in such contexts is on trauma and emergency surgery, the safe care for patients requires for surgery not to be seen as a standalone activity, but rather as part of continuum of care, that includes also NCD management.
There cannot be safe surgery & anaesthesia if we are not able to provide also SAFE perioperative care for patients affected by NCDs.
Especially, when knowing that almost three quarter of NCD related deaths are happening in low and middle-income countries, and in times of humanitarian crises this burden becomes even higher. Health priorities shift towards other acute needs and access to healthcare is way more difficult. There is a shortage of medical professionals, disruption in supply of NCDs drugs and diagnostic tools that leads to interruption in treatment, but also missed diagnoses and lack of awareness.
Several efforts over last decade were made to improve NCD management in humanitarian settings. The Interagency working group, led by the United Nations High Commissioner for Refugees, was composed of members of the World Health Organization, Médecins Sans Frontières, the International Committee of the Red Cross (ICRC), the International Federation of the Red Cross, and others in 2018, published a report "Operational Guidelines of NCD management in humanitarian settings". Subsequently, the ICRC has adapted this report to provide operational guidance to address and address the burden of NCDs in emergency settings through integrated approach that combines ICRC’s overall activities throughout initial, acute and continuing response phases.
https://www.icrc.org/en/publication/4456-managing-projects-addressing-no...
Considering WHO proposed set of Goals to facilitate safe care for NCDs in regards to humanitarian response most efforts will be on Goal 4 (secure access and safe medication) and on Goal 5 (strengthen care coordination, continuity and transition of care). While other three goals are equally important, they might not be fully integrated in the humanitarian response, especially Goal 2 that concerning prevention and risk assessment.
There is still a big gap in addressing NCDs such context but it is great to see that lots of joint efforts a put forward to address these needs.
HIFA profile: Sanja Janjanin is an Anaesthetist with the ICRC, Italy. Professional interests: Patient safety and anaesthesia in LMIC, Global & Environmental health, Conflict & Health. smizlica AT yahoo.com